Conquering the mountain

I hate diabetes because it's physically hard on my son--it's hard to watch Mark suffer when his blood sugar's too high or low. But I also hate diabetes for the emotional toll it takes on him.

And this week, selfishly, on me.

I try not to give too much credence to the emotional toll, like if I don't acknowledge it, it's not really there. But that's just wishful thinking...like diabetes, it's always there.

I don't let Mark use diabetes as an excuse. I remind him he can do anything--that diabetes might slow him down a bit, but not knock him out entirely. He can do whatever he wants despite diabetes--sports, travel, swimming, camping, eating. Everything just takes a little extra work. Our diabetes motto is the same as the Boy Scout motto--be prepared.

"Always take your meter and glucose tabs with you," I tell Mark.

And your mom, I add silently, because Mark would roll his eyes in disgust if I actually said that comment out loud. (Heck, even I roll my eyes thinking it!)

But it's true, I feel it, even if I never say it. I chalk it up to that other feeling I don't want to acknowledge that is also always there. Fear. I don't let Mark use diabetes as an excuse, but sometimes, I use it because I'm fearful. I hate diabetes for making me scared, for turning me into a big ball of anxiety over simple childhood passages like slumber parties or overnight camping trips, for making me want to hide Mark and protect him forever.

It scares the crap out of me, sending him out into this big world alone every day. Since the state requires he attend school daily, I've gotten used to the days. But the nights still scare me. Night time is when all the scary stuff happens, the unexpected lows or random wicked highs, and it usually happens quickly, without warning. No one knows how to care for Mark like I do--no one else sees him wilt as his blood sugar drops, or sees the anger rise as his blood sugar does. No one else has that mother's intuition, which jolts me awake at midnight to check his blood sugar (it's always low when this happens). No one knows Mark like I do, or can care for Mark like I do.

And yes, even as I write that paragraph, I realize how selfish and arrogant it sounds. I don't want to be either, arrogant or selfish, I just want to keep my kid safe.

But my job isn't just about safety, it's also about healthy. Raising him to be emotionally strong and confident, sure of himself, able to care for himself, giving him opportunities to succeed so he knows he really can do anything. Because one day, he'll be off to college, and he will have to do all that. The short-term answer is always the easiest--just do it myself, because I'm faster and more accurate, but really all that does is rob Mark of experience he'll need later in life.

All of which comes back to my worst nightmares: the fear, emotional toll, and selfish feelings I experienced when I saw something as simple as an email about an overnight Scout backpacking trip.

"You wanna go?" I asked Mark, halfheartedly. I didn't want him to miss out, but I also didn't want to chaperone.

"Yes!" Mark answered enthusiastically. "If Sean and Jonah are going."

Sean and Jonah were going.

"It's sleeping out in the open," I told him. "No tents."

"So?" Mark said.

"Lots of hiking," I reminded him. "Probably seven or eight miles."

"Psssh," Mark scoffed. "I can do that, no problem."

And with that, I was officially out of excuses.

The trip was nearby, within 25 minutes of home and across the freeway from civilization, including hospitals and emergency services. The leader-to-Scout ratio was high (five leaders for 20 boys) and one knew Mark well (he was Mark's Cub Scout den leader). Sean and Jonah also know Mark well, and take great joy in annoying Mark by reminding him to check his blood sugar and bolus. There really was only one excuse to keep Mark home.

Fear.

My fear. That stomach-churning, sweat-producing, anxiety-fueled sinking feeling that immediately took over my body. Damn you! I cursed the fear, in my head. But outwardly, I smiled at Mark and left the room, so as not betray my true feelings.

I struggled internally for a few days. He'll do fine, I told myself. He knows how to take care of himself, he's been learning all these years. He's with people who know him, he's with grown-ups I can trust to care for him. Those were the positive thoughts.

He's gonna die, I also told myself. This was the unproductive, super not-helpful thought. There were multiple variations of this thought, but essentially, they all boiled down to one simple fear: that he was gonna die. (I know I'm not the only parent with this fear--all parents have it, in one form or another.) He was gonna die because I wasn't there to watch over him, protect him, care for him. And then diabetes would laugh at me afterwards, triumphantly waving its victory flag above me, finally winning the battle Mark's been fighting since he was two years old.

And that's what finally turned me. I didn't miraculously overcome the fear. There was nothing brave I did, or any noble Yoda moments of wisdom that turned me around. It was just these two simple thoughts: Mark is ready, and I'm not gonna let the fear win.

I let him go. I trained the leaders about diabetes and high/low symptoms to watch for. I still worried, but not exclusively about diabetes. I worried his pack was too big, he didn't have enough warm clothes or water--the things all parents worry  about. I took my sister-in-law's wonderful advice, reminding Mark the day before about everything diabetes-related. And then, on the morning of the hike, I sent my grumpy, sleepy son off to the mountains, telling him simply to have fun.

I wanted to curl up on the couch then, but thanks to my amazing village, I did not. My friend Liz invited me to the movies to get my mind off the trip. My friend Karen texted me when the boys arrived safely from the hike. My cousins took me to dinner, and reassured me I was doing the right thing. One cousin even works for the company that makes Mark's insulin pump, so she's an expert on diabetes. I told her how I'd prepared him, and how nervous I was. She told me I'd done everything right, and I almost burst into tears.

And then, before I knew it, it was Monday. Liz sent me a congratulatory text ("You made it through the night!"). Mark called to say they were on their way home, and just hearing his voice brought me to tears again. He's safe, I told myself. Take that, fear.

I asked Mark a million questions on the way home. I wanted desperately to ask about diabetes--did he check his blood sugar? How often? How was it? Did you bolus? When?

Instead, I asked every other question. Was it cold? How was the food? How was sleeping outside? How was the hike? Did you make it to the top of the mountain?

I asked questions for 20 minutes, about every detail, until finally, I could ever-so-casually ask about diabetes. Like it was an after thought, like it hadn't consumed my every thought until just right now.

"My blood sugar was fine," Mark said. "A little high this morning, but fine. I took care of it."

"I'm so proud of you," I said. "You did a great job managing it. I bet you feel really proud of yourself, too, huh?"

He just stared at me. I thought this would be a big, dramatic moment where it hit Mark that he could do this. I pictured a light-bulb moment, angels singing, harps playing, the epiphany where Mark realized, I got this. I'd beam at him, so proud of his new-found maturity.

Instead, Mark stared at me. Then, finally, he shrugged, and said, "I do this every day. I did the same thing I do every day. What's the big deal?"

And for the third time in 24 hours, I nearly burst into tears. Because it turns out, the epiphany was not Mark's, it was mine. It wasn't Mark who needed the lesson, it was me.

"You're right," I said, giving him a hug. "You do a great job with this every day."

"Are you crying?" he sighed.

"No," I said.

He stared at me, deciding whether to call me on my lie. Finally, he made a safer move and changed the subject.

"We made it to the top," he said. "I am sooooooo sore, but we climbed all the way to the top of the mountain."

"That's awesome!" I said.

Because he did it. He climbed that mountain, literally and figuratively, and came back safely. He took diabetes to the top of the mountain, kicked its butt, and dragged it back down. While I was busy worrying, he was busy scaling mountains.

So, yeah...take that, diabetes.

This is why I hate diabetes...

Mark and I had a super fun Sunday planned yesterday. We were going to see The Life of Pi in the morning, then go for a long bike ride in the afternoon. In between the ride and a Boy Scout meeting, I was going to make Mark a rib dinner using my Mom's recipe (his favorite). It was going to be an awesome day...until diabetes got involved.

Poor Mark woke up with a super high blood sugar--520! Ack! (He should be 70-120.) He also had ketones, which are bad. He told me all this at 7:45 while I was sleeping, then quietly left my room and whispered, "Don't worry, I already corrected."

When I REALLY woke up an hour later, I made him check again. His blood sugar had skyrocketed even more--now, the meter just read HI. He had large blood ketones, and I started to panic. I always tell Mark that low blood sugars are a more immediate danger than highs, unless you've been high for a while and you have ketones--that leads to diabetic ketoacidosis, where your body is basically poisoning itself with acid. That's when you end up in the hospital. 

And that's what was currently going on with Mark's body.

Now I was wide awake. I got the supplies ready to change Mark's insulin pump set, and we found out why he was so high when the already-loosened old set fell off into Mark's hand.

I put on a the new set, gave Mark a whole lotta insulin and a giant cup of water (to help dilute the ketones), and sat back. The next few hours were gonna get ugly.

Mark re-tested 30 minutes later. He was 542. Still dangerously high, but at least he was coming down.

At 10 a.m., he drank a breakfast shake. He said he felt fine, but I refilled his cup with water, and placed a bucket next to him just in case.

At 11 a.m, he re-tested. 482--still high, but coming down. I felt a little better.

At 11:30, Mark threw up. This was my worst fear, what I'd been dreading--it meant the ketones were winning.

I cleaned Mark up and called for reinforcements--the doctors at the children's hospital. (They always say to call in if the kid throws up even once.)

The doctor explained all the things I did wrong (which I knew, because as soon as I said them out loud, I realized what I SHOULD have done--correct the first high with a syringe, check the set immediately). I kicked myself for being lame, for being human, and I agreed with the doctor--yes, I should set an alarm and wake myself up again at night when he's high, yes, I should be more vigilant, yes, I should...blah blah blah. By the time I hung up, I was kinda mad. I'm doing the best I can here, and this was a fluke. This is not how we typically manage diabetes in our house--what I really wanted to know from the doctor was whether or not to take Mark to the ER.

The doc said to take Mark in if he throws up 2 or 3 more times. 

"I'm taking him in the next time he throws up," I told her and she agreed that was fine. She told me to keep the food light--soup only for now. I hurried off the phone to check on my pale little kid.

He felt a lot better, and when he checked his blood ketones, I knew why--they were all gone. But I didn't trust the meter, and made him re-check. Still gone. Mark's blood sugar was down to 327, and it was the only time I've actually been glad to see a number in the 300s. I breathed a huge sigh, and felt like we might actually beat this.

I half-corrected Mark, as the doctor suggested, so all that rage bolusing I'd done early didn't catch up and actually send him low. And then finally, around 2, he felt well enough to eat something. 

I fed him a bowl of chicken soup.

"Is this canned soup or homemade?" he asked, suspiciously. He was finally acting like himself again.

"Canned," I said, and he looked at me, disbelieving. 

"You won't eat it if I say homemade," I said, and he just shrugged and slurped up the rest of his soup. But as the afternoon wore on, he gradually returned to normal Mark, and eventually, most (but not all) of my worry dissipated.

And now here it is, a day later. I can look back with hindsight at all the things I should have done, but it doesn't really help. What helps now is knowing we overcame it, and that not everything was wasted--Mark got to spend most of the day on his bean bag chair in front of the T.V., which he loved. And he got a bonus day off school for Lincoln's birthday, so he didn't lose his whole weekend.

But I'm not as forgiving. Fine, diabetes, you won this round. I may have slipped up this weekend, but I won't next time. I'm gonna keep on you, and I'm not gonna let up. You may have ruined this Sunday, but that's all I'm giving you. That's all you get. 

Until next time....

And after this, I'll step down off my soap box...

Disclaimer: I'm a parent to a child with Type 1 diabetes, and his opinions may differ radically from mine. (But maybe not...these things do annoy him, too.) Anyway, just wanted to point out these are my opinions as a parent, not as a person living with Type 1 diabetes.

Today is World Diabetes Day! I don't usually call attention to it, but I've been bombarded by lots of comments lately that just make me mad. 

But being mad is no good, so instead, I'll use those comments as an opportunity to dispel some myths, and teach people instead. Maybe the next time you get the chance to discuss diabetes, you'll think about this and have a little more compassion (and a little less judgment) when talking to people living with diabetes.

(Also, I could get into a big ol' discussion about the differences between Type 1 and Type 2, but really, what does that matter? Living with diabetes is hard no matter what type you have.)

1. My son didn't get diabetes from eating too many candy bars.
 
His diabetes is an autoimmune disease--he got it from drawing the short stick in the gene pool. When he was two years old, his body actually waged a war against itself, attacking and destroying the beta cells that make the insulin Mark needs to regulate his blood sugar.

That war broke his pancreas--it doesn't work, and there's nothing Mark did or ate that ruined it. He's not an undisciplined sugar addict--he's actually a survivor, a warrior. Hold your head high, Mark--you have a lazy pancreas, but an iron will (and an external pancreas you carry in your pocket)!

Oh, and by the way...statements like "he ate too much candy" just make you sound like a righteous, grumpy old man yelling at the neighborhood kids to get off his lawn. Seriously.

2. He can't have sugar.

Sugar is just a carb. Almost everything you eat has carbs, and eventually turns to sugar when you digest it. Even stuff that's good for you--fruit, milk, bread, pasta. (Would you deny a non-diabetic kid an apple or banana?)

Telling Mark not to eat sugar is only looking at diabetes like a short-term problem. It's not about what he should or should not eat right now; it's about the big picture, establishing good eating habits for a lifetime, not just for this meal. Mark eats like we all should eat: healthy, balanced meals, with occasional treats.

What Mark needs is understanding, not a lecture from the food police. As his mom, I appreciate you checking to see if he can eat something--I know that's coming from a good place, from your concern over his health. I appreciate that.

But you wouldn't want everyone telling your mom every single thing you ate; neither does Mark. He knows how to count carbs, how to bolus insulin for his meals. Reminding him to do that is much more helpful than asking him if he's "allowed to eat that."

3. Sometimes he DOES need sugar.

When Mark has been really active, or gets too much insulin, his blood sugar goes low, which is dangerous. It means he needs sugar RIGHT NOW. Usually it's a juice box or glucose tablets, but sometimes it's whatever is close by. That might be soda, or hard candy.

What Mark needs at that moment is...sugar. 

And what I need to do is make sure his blood sugar is going back up to range. While I appreciate your concern for Mark's health, what he needs to do is to eat or drink--not to be lectured on why sugar is bad for people with diabetes, or if it's a good idea to give him sugary drinks.

Sugar, is in fact, sometimes the remedy, not the enemy. 

4. He's not going to "grow out of it."

His pancreas is broken, period. It's never going to start up again when he grows up, if he eats better or loses weight. The only thing that'll make it go away is a cure, something I pray will happen in Mark's lifetime.

And no, insulin is not a cure. A new insulin-producing pancreas is a cure; but in the meantime, external insulin is kind of like duct tape; it's just a temporary fix.

5. I'm sorry about your grandma/grandpa/aunt/uncle/elderly relative. But please stop scaring my kid.

I'm sorry that someone you know or love has diabetes. And I'm more sorry that they lost a limb, appendage, or their eyesight to it.

But I'm most sorry you're telling these stories to or in front of Mark. Stories of lost body parts do not help or motivate him. He's a little kid--it scares him. And it shames him, because the underlying message of your story is not, "Wow, diabetes sucks," it's really, "You are gonna get your leg cut off if you don't take care of yourself."

Mark doesn't think long-term about diabetes--that's my job. I teach him how to manage his diabetes now so that he can take those good practices forward into adulthood with him. Mark knows about diabetes complications, probably waaaaaaaay better than you ever will, because he experiences them (on a smaller scale) every day. But cut him some slack, he's only 12, and he's just trying to get through middle school--with all his limbs. 

Many people do have complications because of diabetes (including losing limbs), but it's not guaranteed to happen. Let Mark and I worry about the long-term stuff.

6. Yeah, he doesn't like needles, either.

I know; you hate needles, and you could never prick your fingers five or six times a day. But maybe you could keep that thought to yourself while Mark's checking his blood sugar.  Because guess what? Mark hates needles, too! You should see him freak out every year when I mention the flu shot. He's not using needles or pricking his fingers because he wants to; he does it because he has to. It's not a luxury for him; it's not something he can ignore because he doesn't like needles. No one likes needles.

But Mark takes care of business every day, whether he likes it or not, and I'm pretty damn proud of him. Sometimes he makes mistakes, sometimes I make mistakes, but we're doing the very best we can. And what we really need is support, not judgment.

So that's it. Those are the most common stupid things people say OUT LOUD when they realize Mark has diabetes. I don't want to limit people's questions, I just want them to take the shame and blame out before they ask them.

I don't mind questions. I WANT to teach you about diabetes, especially if it makes Mark safer when he's in your care. So ask away...just use a little respect. Because even though I do kid around about about it sometimes, diabetes isn't just a joke or a punch-line to me.

For more information about diabetes, visit these web sites:

World Diabetes Day
 
JDRF
 
American Diabetes Association 

Diabetes is no day at the beach

Pre-kid, I loved going to the beach. It was so easy--pack up a chair, a towel, some sunscreen and a good book, and I was good to go for the whole day.

I still love going to the beach, as does Mark. It just takes a lot more planning now. Diabetes isn't the problem; it's Mark's insulin pump.

I love that pump. It's a modern-day miracle, an example of how technology improves our lives. It makes Mark's life easier, more discreet, and it freaks people out a lot less (diabetes quickly shows you who your squeamish, needle-phobic friends are).

It's also a sensitive, incredibly expensive medical device that does not play nicely with things such as, oh, say, large bodies of water or acres of sand.

A trip to the shore now requires careful planning. I learned the hard way to bring extra pump supplies, insulin, and even needles to the beach. When my mom wanted to take Mark, I taught her to remove his pump and cap the infusion site so sand wouldn't get in and jam it. She did exactly that, but sand still got in and jammed it--then she couldn't remove the cap OR plug the pump back in. Poor Mark suffered silently as my mom and brother Brad poured water down Mark's backside, trying to wash the sand out. They finally just removed the set, and I left work early to go put in a new one.

Now, we just unplug Mark and cover his site with medical tape. I bring needles and insulin and give him shots whenever he eats, or needs basal insulin. And I accept the fact that Mark will most certainly lose his set, and require a new one when we get home. I chalk it up as a small sacrifice to the beach gods, a minor price to pay for my sun-loving son's happiness.

However...all that careful preparation goes out the window on field trips. While a day at the beach with me is...um, a day at the beach...it's a different story when I'm not there. Instead, I have to trust that my 11-year-old son will:

• Remove his $6,000 insulin pump before burying himself in a hole or frolicking in the heavy surf (the first time Mark wore his pump in a pool, it fell out and sank to the bottom. I've had nightmares about water vs. the pump ever since).
• Tape up his site before even one grain of sand jams it.
• Put the pump in his beach bag after he removes it.
• Give that bag to a responsible adult.
• Plug the pump back in when he leaves.

And this year, I added a new task: Give himself a shot for lunch.

That one has me biting what's left of my finger nails. Kids on needles (instead of pumps) take both short-acting and long-acting insulin, so their blood sugar won't go super high if they miss a shot or two. But Mark's pump uses only short-acting insulin--so even a few hours without insulin is really dangerous, as we were reminded a few weeks back when his pump malfunctioned. (His blood sugar shot well over 600--three hours later, he was only down to 585!)

In previous summers, I spent my lunch hour driving to whatever beach Mark was at, and giving him the shot. But Mark wants to be like every other kid, and nobody else's mom shows up at the beach wearing jeans and shouting "Did you eat yet??" as she plows through the sand.

So I'm trying to give him independence. I'm trying to let him manage without me today. I'm telling myself he did remove his pump, he did put it back on, and he did give himself his shot. I say it over and over again, so that it sounds real, and plausible. I say it like a mantra, so it will seem comforting, and I say it in my head, in my most soothing, calm internal voice.

But it's not working. I'm still a mess, and I will worry until the moment I pick him up from summer camp and blurt out, "What's your number?" before I even ask him how his day was. When he gets mad that's the first question out of my mouth, I will get mad, too, even though I'm not really angry at all, it's just my worry and fear being projected as anger.

The honest truth is that Mark is responsible, much more than most kids his age, because he has to be. But it's too much; it's too much to ask an 11-year-old to guard his health rigorously, religiously, even for half a day. That's my job, and even though I know I'm giving him life skills, experience, the confidence of knowing he can take care of himself, it's killing me.

Because even as responsible as he is, as I ask him to be, he's just a little kid who wants to dig in the sand, eat his lunch without mom, and be like every other kid on the beach.

Which, really, is all I want for him, too.

Celebrating National Diabetes Day

Sunday is National Diabetes Day, so in its honor, I am giving the spotlight to the disease that has transformed my life by way of the young, brave boy I proudly call my son.

Mark has taught me what it means to be strong and brave, what it means to live daily with a chronic disease when all you really wanna do is just be like everyone else. He has taught me what strength and bravery really are. He has taught me that life isn't fair, and while it's okay to whine about that occasionally, it's not really a place you want to spend a lot of time in. He has shown me that living with a chronic disease still means living, celebrating, rising above, even when diabetes tries to beat him down. He has taught me to be an advocate, to fight not only against diabetes, but for him, and for other kids who also live with this monster every day. And I'm glad, too, to take on that fight, because I know one day, when I'm tired of fighting it and think I can't go on, there will be a cure. That thought alone keeps up my strength, and my resilience.

Five years ago, I didn't know anything about diabetes. I was completely ignorant about it, and thought it was a disease you got from being unhealthy, or that old people got. I thought a diagnosis automatically meant losing a limb, because mention the word "diabetes" and everyone will share a story about their grandma/grandpa/great uncle/elderly neighbor getting their foot or leg or finger amputated.

I thought diabetes meant you got an occasional shot, some orange juice if you got shaky, and a lecture from your doctor for making yourself diabetic in the first place. I thought it was some weird disease that made you shake and eventually killed you just because you wanted one thing (a baby) more than anything else in life, even living. (Yes, Steel Magnolias was my favorite movie.)

I thought a lot of things. And I was wrong about most of them.

I learned that diabetes doesn't just affect your blood sugar, it also changes the way you see the world. It looks like an angry little kid who misses out on school parties because no one can give him a shot for that cookie. It looks like a pale, shaky little kid whose blood sugar is so low, you can barely think through the fear long enough to shove a juice box into him. It looks like a bad habit, falling asleep on the couch every night, instead of in my bed, so I wake up to test Mark's blood sugar.

Diabetes feels like a lot of things, too. It feels like fear, worry, anger (which is always really just a subset of fear), my heart breaking--why did it have to be my kid? Or ANY kid? Or anybody?

But those are the dark moments. I try to focus on the good things it feels like, such as gratitude, gratefulness, a lump in your throat you can't name when people bend over backwards to accommodate this goofy little kid on something as mundane as a field trip.

It feels like a giant hug from random people, strangers really, people you wouldn't ever have met except for this one crazy coincidence--they too, have a little kid with a chronic disease. They, too, have bad sleeping habits and worry incessantly over Halloween and Easter baskets. They, too, know how you feel.

It feels like pride, when that kid learns to poke his own finger, read his own numbers, count his own carbs, bolus his own insulin. It feels like an angry hive of bees buzzing around your head when he ignores all those steps, and it feels like all-consuming guilt when you realize he's just a little kid who shouldn't have to remember all that in the first place.

But mostly, on both my best and worst days, it feels like hope. Hope that my kid will learn to co-exist peacefully with his disease. Hope that maybe they really will find a cure in his lifetime--heck, they created continuous glucose monitors and insulin pumps in the last 20 years alone! Hope that this little kid brought to the rest of my family, who have been diagnosed with their own flavor of diabetes in the past few years. Hope that while diabetes may not be beaten, it also won't beat us down, either. Hope that because of this damned disease, I have learned a lot, so much, and that I can pass that knowledge to other parents, walk them through their own scary initial journeys into this dark tunnel. Hope that I can gift them, to say it really is just a tunnel, and that every tunnel has an end. And at the end of each tunnel is your kid, or your loved one, that one person you would slay dragons to keep safe.

So take that, diabetes. You may get your own day, but even that day celebrates hope. Hope that education, that a cure, that your disappearance, will prevail. It's not a day to celebrate your existence, but rather to celebrate our rallying against you.

A day I can't wait to embrace, when my son finally rips off his pump, tosses away his meter, and eats his fill of jelly beans because he wants to, not because he has to.

A day when I hear the last story of amputation someone tells in front of my kid...except for the amputation of you, diabetes, from our lives.

That one I can't wait to hear.

Pfc. Dinsdale

Mark sometimes talks about what he's gonna be when he grows up (a video game developer, a teacher). But yesterday he spoke angrily of what he cannot be.

"It stinks that I can't be in the army when I grow up!" he said. You can't enlist in the military if you have dia betes; you can stay in if you're diagnosed while serving, but you have to show good control.

This is a big deal for a little kid; Mark loves playing army, either with his friends or with his toys. I don't think the army would necessarily be a good fit for Mark anyway -- he doesn't respond well to authority, to getting up early or missing sleep, and he doesn't like to hustle. I think he'd have a short military career for those reasons, but hey, no need to kick a kid while he's down.

I spend a lot of time telling him he can do anything, and that dia betes can't stop him. So I don't blame him for being mad, or feeling left out of the one thing he might actually want to do but can't.

"Well, there's that guy we saw on D Life," I answered. I reminded him of a soldier who discovered he had Type 1 just before being shipped off to Iraq. He proved to the army he could manage his dia betes, even during war, and was allowed to stay in.

"Yeah, but he didn't have it when he joined," Mark said.

"Well, maybe you could argue your case," I replied.

"Argue?" Mark raised his hands up, flabbergasted. "With the ARMY??"

OK, so maybe he has a better grasp of the military than I thought.

"Who knows?" I said. "Maybe it would work. You never know."

He shook his head. "I've already tried," he said.

I started laughing. "Oh, really?" I asked. "You've tried to enlist before?"

"Yep," he answered. "A bunch of times. They keep saying no."

Maybe that's why he doesn't finish his homework -- he's too busy talking to army recruiters after school.

Anyway, I was glad to end the discussion with laughter. I know he was teasing, but I also know it bothers him to be told no because of his crappy disease.

And I plan to stoke that indignation. I'll still tell him he can be anything he wants to, but sometimes telling him what he can't be is more motivational. Nothing like a little bee in your bonnet (or army helmet!) to spur you into action.

Stop talking, start eating!

The frustrating thing about managing dia betes is that it isn't really manageable at all. It's not like a schedule, which you plan according to what works best for you. No, dia betes is more like a naughty child; you can ignore it for only so long before you must address its behavior.

With each new season -- summer, school, soccer -- Mark's in sulin needs change. He's growing, and during growth spurts, he needs more in sulin. He's playing sports, so he needs less in sulin. Or he's sitting still in class all morning, and needs more in sulin, but then he's really active all afternoon, so he needs less in sulin. It's a slippery slope.

It's Day 7 of school, and I've been constantly fine-tuning Mark's in sulin pump. He's had a lot of lows, so I'm troubleshooting a lot -- is he low because he didn't eat all his lunch? Does he need less in sulin for his meals, or a lowered basal rate (the amount of in sulin he receives continually)? Or both?

Yesterday Mark was low almost all day long. I don't have dia betes, but here's how I describe lows (based on what Mark's told me): You know when you've waited too long to eat, and you're so hungry you can't think any more? You're emotional, you're cranky, you're dizzy and you can't think straight? You're so low energy you feel like you just want to lie down and sleep? That's what lows are like, and they usually subside after eating something.

But poor Mark felt like that all day yesterday. He was low at 9 a.m., 11 a.m., 1 p.m. and during soccer practice after dinner. The nurse called me each time, and though the answer was obvious (program Mark's pump to give less in sulin), I couldn't fix it until we got home.

So instead, we treated the lows by feeding Mark. He ate breakfast at home, then two snacks before lunch. After lunch, he had three more snacks, then came home for dinner. Which still wasn't enough, because all the running during soccer sent him low again.

I was troubled that my little boy felt so bad all day long. I finally unhooked the pump for an hour just to let his blood sugar come back up.

But Mark saw the silver lining. Where I was bothered by the lows, he was thrilled by the endless buffett.

"Were you bummed you had to eat so much?" I asked him. He loves to eat, but sometimes the forced feedings push him over the edge.

"No!" he answered happily. "It was awesome! I ate all day long!" He smacked his lips, and smiled at the thought.

So I guess that's the silver lining, the thumbing our nose at dia betes. Mark may not have felt his best, but he spent the day doing what he loves best -- eating.

I guess the naughty child didn't win after all. At least, not today.

Perhaps I spoke too soon...

One of my nephew's friends, Alan, came to brunch with us on Monday. Alan was diagnosed earlier this summer with Type 1 d i a b e t e s, and spent his summer l e a r n i n g to carb count and give himself shots. He and his parents have done a great j o b adjusting, and l e a r ning, and it really showed.

Alan ordered a low-carb breakfast so he wouldn't need a shot. Mark, who has a pump and not nearly the discipline that Alan has, ordered a huge plate of french toast. That french toast looked yummy, and after a while, Alan couldn't stand it. Tim handed him a slice, and Alan broke off a small bite to taste it.

I explained that we do the same thing at our h o u s e. My rule on eating is that for snacks and meals, whatever goes in Mark's mouth must also go in his pump. (Meaning, if he eats anything, he must program the pump to give himself i n s ulin for the food.) But for tasting small samples or bites of stuff -- well, I'm a little more relaxed with that.

"We have a saying in our house," I told Alan. "One bite won't kill you."

Alan nodded his head. What I didn't know was that at that exact moment, at the other end of the table, Mark was experimenting. He'd put Tabasco sauce on his french toast to see how it tasted.

I'd literally just finished telling Alan that one bite won't kill him when Mark started screaming.

"My mouth is on FIRE!" he shouted. "My lips are burning!" He gulped down his water and smeared sugar-free syrup on his lips to quench the burning. None of it worked, and he kept screaming in agony.

I just shook my head and sighed. I looked at Alan and said, "OK, I take that back -- I guess one bite might kill you!"

Only my kid...

The kindness of strangers

Mark went on an all-day field trip today, and for the first time ever, I didn't go with him. He's been managing his diabetes pretty well, and his teacher feels comfortable with Mark's diabetes, so I thought it was time to reward Mark with a little independence.

And then, the best-laid plans all went to hell.

First, Mark dropped the diabetes ball, and made a really bad choice. Luckily, his amazing school nurse saved the day. Then, late yesterday afternoon, she phoned to say the teacher wasn't actually going on the field trip, a substitute teacher was.

That put us both into a bit of a panic! I couldn't take the day off, and she wasn't working, so we did a little troubleshooting to handle the situation.

The nurse came up with the best solution ever -- she enlisted the mom of another student with diabetes to substitute for Mark's class. This is a kid we both respect and admire -- he's in 8th grade, and a shining example of how to manage your diabetes. I figured any kid like that must have a pretty awesome mom. :-)

So today, instead of reporting on Mark's usual shenanigans, I'm here to praise the diabetes and nursing communities! I'm telling you, spending an afternoon in the company of families living with diabetes will renew your faith in humanity. They are the most helpful, caring people you could meet, always willing to give a hand, some advice or a quick-acting sugar source if needed.

And the people who help care for our kids -- people like our school nurse -- are literally guardian angels. I can't heap enough praise on her, or the school nurses that Mark had before her. It's the scariest thing in the world to hand over your kid and trust that someone else will keep him safe. She keeps him safe, keeps him laughing, and has become not only his nurse, but his friend as well. (And she's a wonderful sounding board for me as well!)

So thank you, Nurse King, for going above and beyond caring for Mark. And thank you Roman's mom, for knowing exactly which questions to ask, and for agreeing to watch over my son when I could not. You'll never know how much that meant to me! (Or maybe, as a fellow mom of a child with diabetes, you will...but you still have my gratitude.)

An open letter to diabetes

Dear diabetes,

This was Mark's spring break, and while I knew you'd spend it with him, I hoped you'd be a little more considerate. He's just a little kid -- you could've let him enjoy some of his time off!

I know you like attention, but really, this was ridiculous. You were really a pain in the neck all week! You started Monday morning, when I inserted Mark's new set into his belly, which he hates. You could've just stuck him and got out, but nooooo, you had to make him cry.

It continued Monday at lunch, when Mark wanted to be just like all the other kids, and "forgot" to test his blood sugar before lunch at camp. He overcompensated with his lunch dose, and sent himself low.

Then, Monday night, Mark's set fell out after only 10 hours (they usually last 3 days), and I had to re-stick him on the other side of his belly. Re-cue the crying.

No problem, I thought, at least we're good until Friday night. But you had other plans. Mark called me on the way home Tuesday afternoon to say the SECOND set fell out. Cue set number three.

It's odd to lose two sets in two days, but we went with it. You won't beat us diabetes, I thought, but you took up the challenge. Yesterday, Mark spent the whole day high, and I could almost hear your cackling. Lunch was 357, which I attributed to a freakish high. Dinner was 481, which Mark attributed to s'mores at camp. 10:30 check was 477, which I attributed to onion rings at dinner. I should have replaced the third set right then (and would've if he'd had ketones), but new sets send Mark low, and lows in the middle of the night are SCARY.

So I held off for one more test, and then you really got me. No number this time, just HI. Yes, I know that means Mark was over 500. 500!!! (He should be around 160 at night.) Curse you, diabetes!

Yes, I sent Mark to the bathroom, AGAIN, for the third time since his 9 o'clock bedtime, so his body could get rid of all the extra sugar. And yes, that was me, at 1 a.m., fumbling for the insulin bottle, new set and new cartridge with my eyes half-open, which I then shot into Mark's bum while he slept. I prayed he would go lower (but not too low) in the next four hours.

Yes, that was me, waking in a panic when I heard Mark fumbling around this morning.

"What's your number?" I called out, even before saying good morning, and again I cursed diabetes for robbing me of the most basic social graces.

"I didn't check yet," he answered, but moments later, I heard the familiar beep of the meter, and he called out "75."

Which meant we'd finally hit the other end of the spectrum. "Eat your breakfast RIGHT NOW!" I called out, and through the baby monitor, I heard him sigh and say, "OK."

And so I sent Mark off to camp. He didn't have his meter, because the counselor accidentally brought it home yesterday. (I really hope he brings it back, but I brought my extra meter just in case I have to drive up at lunch.)

Mark wore his favorite hat, his favorite Dodgers jersey, and some dark circles under his eyes courtesy of last night's high sugar roller coaster. I thought he'd be kinda cranky, but instead, he was thrilled to spend his last day at camp with all his new friends.

So, take that, diabetes. You tried, you really did, to steal his week off and make him miserable. But it didn't work, and I'm here to say nyah nyah nyah nyah nyah! I know, not exactly the most mature response, but so what. I'm a little sleep-deprived this morning, and feeling overprotective of my boy.

In closing, diabetes, I just want to say you stink. You made things rougher than necessary for my kid this week, but he still had a blast. He enjoyed his spring break anyway, no matter how many curveballs you threw his way. You tried to shut him down, but only succeeded in slowing him down a bit.

So, nice try diabetes. But you picked the wrong kid to pick on this week.

Heather

Wash with care

I may have mentioned it before, but diabetes is a tricky disease. You can follow all the rules, but it still has a mind of its own.

Some diabetes management tasks are clearly visible -- spend more than a couple hours with us, and you'll see Mark check his blood, correct a high or low, and count carbs before he boluses. But other tasks -- tasks you and I take for granted -- are much trickier.

Such as bathing. Chances are, you jump in the shower without a second thought. Not so for Mark.

The first time bathing became an issue was when Mark got his insulin pump. Suddenly he had this extremely expensive device that was waterproof, but not heat-proof. He can wear the pump in pools, but hot water cooks the insulin, making it a bad idea in the bath.

Then there were the sites. The pump is connected to Mark through a tiny cannula (plastic tube) stuck into his skin with a needle. It has an adhesive that keeps the site on Mark, and if we're lucky, it sticks for about three days.

Except when you submerge it in water. Then it peels off, and Mark gets another opportunity to shoot a needle into his body. As you can imagine, he declines this opportunity every chance he gets.

The temporary solution to losing sites was to eliminate baths. Instead of a nightly bath, Mark took a bath every three days -- that way, if the site fell off, it was time to change it anyway.

I mention this was a temporary solution because any of you who have or know little boys also know that a bath every three days is...well, not optimal. Turns out these little critters are excellent at attracting dirt, and the..."aromatic"...smells that accompany dirt infused with little boy sweat.

So I embarked on a mission to keep Mark's sites on in water. I tried numerous clear adhesive products with wonderful names like IV3000 or Tegaderm, which didn't work. I cemented the tapes using a liquid adhesive called Skin-Tac, and that worked better, but Mark still lost sites with alarming regularity. (Oh, and did I mention the sites run about $40 a pop to replace?)

And so I went to the boards...the www.childrenwithdiabetes.com boards. Where the parents suggested another product, called OpSite Flex-Fit tape. It worked like a charm! Suddenly, Mark's sites stayed on. He showered one, then two, then THREE days in a row, and we didn't lose the site! He got out, I gave him the insulin he missed while disconnected from the pump, and life was good.

It was a miracle, and I celebrated it as such. Until...I tried removing the tape. Which refused to come off. And sent Mark into a screaming fit as I doused it in Uni-Solve three times, and then finally ripped it with all my might. Mark was in tears, but the site finally came off. I couldn't believe it -- first I couldn't get the sites to stay on, now I couldn't get them OFF!

I went back to the boards, and this time the parents recommended a product called Medi-Sol. That did the trick -- Mark's sites peeled off easily, and we were back in business. He started a new nightly bath regimen, and was thrilled. (He really likes baths!)

Except...now the daily bath has sent his little body into a series of low blood sugars. Apparently, hot water opens up your arteries, which causes the insulin to rush through and burn out much faster than it's usual 2-hour time frame. Which means I can't give him the insulin he missed while in the bath (it sends him even lower), and around 11 p.m., he shoots waaaaay up to the 300s.

So nw we're on a new schedule. I give Mark his insulin as soon as he gets home, around 6 p.m. We eat, wait 90 minutes, then I give him a small, uncovered snack (to keep him from going low), and put him in the shower. When he gets out, I give him the missing insulin, cover the snack, and cross my fingers. So far, my success rate is hovering near 50%.

I'm certainly not complaining, and I'm not whining about how hard diabetes is. It's just fascinating to me how much work and thought diabetes requires for things as simple as bath time, and how dire the consequences can be for Mark if I judge incorrectly, or bathe him too soon after dinner.

To you and I, it's just a shower. To Mark, it's a whole science experiment, and another chance to outwit diabetes. Unfortunately, as is often the case, diabetes is a formidable opponent.

Word of the day: Grateful!

I've become so used to diabetes now that finger sticks and bolusing (giving insulin) are second nature for me. It's the same for my family and friends -- no one panics anymore when they see a low number on Mark's meter -- they just automatically hand him a juice box.

And as Mark gets older, he's become more responsible. He checks his blood sugar, counts carbs, boluses, and corrects lows or highs by himself. (Pretty amazing feats for an 8-year-old!) Because of that, I worry a lot less when I'm away (after school, with babysitters, etc.).

But it is still nerve-wracking to leave him in someone else's hands. There's the whole notion that no one takes care of him as well as I can (not true!) vs. the idea that time away gives Mark (and his caretakers) more opportunities to succeed and thus, more confidence.

Yesterday was a definite confidence builder. My brother Scott invited us to Disneyland, with our brother Brad, his wife, and all the kids.

"I can't," I told him. "I'm going to a baby shower."

"What's Mark gonna do?" Scott asked, and I said stay with a babysitter.

"He'd rather go to Disneyland!" Scott said. "Send him with Brad and Brandy."

He was right -- Mark would rather go to Disneyland with his cousins, aunt and uncles. But my brothers haven't watched Mark on their own before. (Scott's wife Mary usually manages Mark's diabetes when they babysit, but she was working.)

"Really?" I asked. "You'll test him before lunch and count his carbs?"

"Yeah!" Scott said enthusiastically. "He'll be fine!"

Wow, that was huge. Taking four kids, a toddler, AND diabetes to Disneyland -- now that's a commitment!

So I checked with Brad, who said no problem, they'd drive Mark. Then I told Mark, who was thrilled. I was pretty thrilled, myself -- not only were my brothers watching Mark, they were giving me a whole day to myself!

So Sunday morning, I packed up Mark's meter, some juice boxes, his Disneyland pass, and $20. I reminded him to check his blood sugar before lunch ("I know, Mom!") and to text me his lunch menu so I could count the carbs.

"I want to estimate the carbs myself," he answered, and who was I to look a gift horse in the mouth?

I told him, "Great! Text me the estimate, so I can help if you need it."

I dropped him off at Brad and Brandy's, and he was so excited, he about pushed me out the door.

"Bye, Mom!" he said, and ran off to play with Johnny.

Then I went off to an early movie with Edra, still dazed and delighted at this sudden good fortune.

I hadn't heard from them when the movie let out at 1, so I called to see what Mark ate for lunch. Nathalie informed me he hadn't eaten yet, and I bit my tongue.

"OK," I said. "Tell your dad it's time for him to eat." Don't panic, I told myself. If Mark was starving, he would've told Scott.

Five minutes later, Brad called, asking how many carbs were in a hot dog and chips. I told him, he said okay, and hung up. I couldn't believe how easy it all was!

I went off to the baby shower, and thoroughly enjoyed myself. I got one more call, asking if Mark could have ice cream. "He's looking up the carb count right now," Brandy told me.

"Definitely, he can have it!" I told Brandy.

An hour later, I picked Mark up from Brad and Brandy's. He'd had a great time, and no one seemed traumatized. I couldn't stop beaming.

And so today, I am grateful. Grateful to Scott, who invited Mark along without hesitation. Grateful to Scott, Brad and Brandy for taking such great care of Mark, and giving him something he loves -- a day with the family. And grateful to my whole family for coming along this journey with me, reaching the point where "Mark, my nephew with diabetes" simply becomes "Mark, my nephew."

It sounds like such a small thing, but really, even today, I am overwhelmed by it, and soooo proud of them all! My brothers gave me such a huge gift yesterday, and for that, I will always be grateful. For Mark, it was just another day in the park, but for me, it was the day my brothers rose up, and succeeded beyond my wildest dreams.

And you can't get more confident than that!

Sometimes the cure hurts worse

I'm proud to say we walked 31 miles to help cure diabetes yesterday! (OK, it was actually only 3.1 miles, but it felt like 31.)

It was the American Diabetes Association's annual Step Out walk, a fundraiser for diabetes education. But when you're a little kid, that's kind of a broad concept.

"So we're raising money to cure diabetes?" Mark asked, and I nodded. He was cool with that.

My cousin Kathleen, ever the good sport, walked with us. We melted into the large crowd, which was very inspiring. People wore team shirts and memory stickers-- "I'm walking in memory of my mom" or "I'm walking for my daughter." There was a boy from Mark's school with his team--"Roman's Motley Crew"--all dressed in blue shirts. It was impressive to see how many middle schoolers (and even the school nurse!) he'd dragged out of bed early on a Saturday morning to join him.

We did a group stretch and headed for the starting line. They rang a bell, and we were off.

It was a gorgeous day--sunny, and warm. We walked along the ocean, taking in the beautiful views. You could only go as fast as the people surrounding you, so it was a nice, leisurely pace. Mark, ever the rebel, decided to walk just off the path, in the dirt next to us.

That was mile 1. It went pretty quickly, but soon, Mark slowed down a bit. I thought he was going to complain, but then he saw a water station. Talk about motivation! He bolted through the crowd, and grabbed a bottle of water--there's nothing that kid loves more than free stuff.

Unfortunately, even the water couldn't distract him for long. Ten minutes later I heard the words I'd been dreading for the first time.

"How much longer?" Mark asked.

"You're doing great, Mark!" I replied, cheerfully. "Isn't it great how many people are walking to cure diabetes?"

But he wasn't falling for it. He just growled.

Kathleen and I resumed our conversation, but it wasn't long before the next interruption.

"How much further?" asked Mr. Grumpy Pants. "This is boooooring..."

"Not much," I lied. I pointed to the ocean, and encouraged him to look for dolphins or seals. I reminded him how I saw a dolphin at this very spot and he responded--yes, again--with another growl.

Now he was walking 10 feet behind us, and grandmothers were passing us. Seriously! I'm not talking young, fit, first-time grandmas here--I'm talking older, stooped, white-haired grandmas, pushing frail, elderly grandpas in wheelchairs, followed by ADULT grandchildren!

I did my best to ignore Mark, silently pulling Kathleen to the side to wait whenever he got too far back. "Come on, buddy!" I called to him. "The faster you walk, the faster we'll find the cure!"

(Which yes, I'll admit, is a flat-out lie, but whatever. You motivate with whatever works!)

Only it wasn't working. We passed mile 2, and I called out, "Only 1 mile left! Keep going!" It didn't help at all. In fact, he started falling even further behind.

By mile 2.75, I was starting to drag a bit. I was getting hot, my shoe was rubbing a blister into my foot, and waiting every five minutes for Mark to catch up was wearing thin. Kathleen took over the inspiration baton--"Think how good it'll feel when we complete the whole thing!" she called out. "Come on, Mark, keep walking!"

By mile 3, Mark finally caught up to me, and grabbed my hand with his own sweaty little one. "How much looooonger?" he whined, tugging at me, and I automatically answered, "We're almost there..." Luckily, he saw the water station again, and raced for another free water, even though he was already clenching a half-full bottle.

Now walk volunteers were manning the route, clapping and cheering us on. "You're doing great!" they shouted, "It's almost over!"

Instead of inspiring me, their cheeriness irritated me. "Why are they so damn happy?" I asked, grumpily, and Kathleen (who was still chipper) answered, "Because they didn't walk anywhere!" I thought of our own cheerleading role at the marathon last week, and wondered how many walkers we'd irritated.

But in the end, we made it. I tried to challenge Mark--"Let's race to the finish!" I called, but he wasn't having it. Kathleen and I crossed the finish line to cheers and ringing cowbells, and Mark sauntered in after us. "You got beat by a couple of old ladies," I told him, but he just shrugged.

And so we did our part toward raising awareness and finding a cure for diabetes. Mark talks a lot about what will happen when they do find a cure. As for me--well, I just hope when they do find the cure, it doesn't turn out to be at the end of a 3.1 mile line. Because if it does, I know a certain little boy who really will have diabetes for the rest of his life!

Sometimes, it's just a numbers game

File under: Dumb little things that become serious big things for kids with diabetes...

Mark's substitute nurse called while I was waiting for my oil change. Which was odd, because it was half an hour past lunchtime, when I usually get calls.

She said she bolused Mark at lunchtime, but he just came in to say he didn't eat. Apparently, his Powerade juice pouch popped and ruined his lunch, so he didn't eat (instead, he played on the playground). He was bolused for those carbs--55 of 'em--but hadn't eaten any.

I did the math in my head, but the nurse beat me to it.

"He got the insulin 25 minutes ago--so what should I do?" she asked.

Fast-acting insulin works in 15 minutes--which meant his blood sugar was already dropping. If we didn't replace those carbs immediately, we could have a bad scene on our hands.

I thought quickly. "He's got raisins in his backpack for snack," I said. "That's 33 carbs. And he has extra snacks there with his diabetes supplies--give him a South Beach bar. That should almost cover it--and make sure he eats there in the office with you!" The nurse agreed, and went off in search of the food.

She called back 10 minutes later to report almost all the carbs had been replaced. Mark had a wonderful lunch of peanut butter crackers (16 carbs), a South Beach bar (15 carbs), a juice box (15 carbs) and two glucose tabs (8 carbs).

Healthy and nutritious lunch...eh, not so much. But sometimes, when the insulin is coursing through Mark and the clock is ticking, healthy doesn't matter as much as cramming for carbs and hitting that magic number.

And have I mentioned lately THANK GOD for school nurses???

525,600 minutes

"Five hundred twenty-five thousand, six hundred minutes
Five hundred twenty-five thousand moments so dear
Five hundred twenty-five thousand, six hundred minutes
How do you measure, measure a year?"
----"Seasons of Love" lyrics from the musical Rent

Today is our official Adoption Day--exactly one year ago today, Mark and I (and our family and friends!) sat nervously in the Children's Court and listened to a judge finalize our adoption.

It was the legal beginning of our lives as parent and child, and the happiest day of my life. But not for the reason it should've been...

I'd always imagined adoption day would be joyful and proud because I officially became a mother. But honestly, it felt more like...well, not the end, really, but the sense of closure was much stronger than anything else. The biggest benefit to the adoption was the state now recognized me as Mark's legal mother, instead of treating me like a glorified babysitter with no legal say in Mark's care.

The thing is, I'd already had Mark for two years. I'd struggled, learning what it really meant to be a mother, and a single one at that. It was so much more than making sure he had clean clothes, hot meals, and a band-aid when he cut himself.

I struggled with Mark's diabetes--how to manage it, how to recognize Mark's high and low blood sugars, how to feed him and when. As a single person, I slept all night long without a care in the world. As a new mom, night time became the scariest time in my life--would Mark go low while I slept obliviously? I woke often at night to test and correct him, and placed a baby monitor in his room and mine. But even that wasn't enough--I spent lots of time standing in his doorway, watching him sleep, making sure he was still breathing.

I struggled with Mark as an angry little boy. He hadn't been told anything prior to moving in with me, and what he knew made him mad. He was shuffled between families (birth, foster, and the newest family, me), ordered to visitations by a court that knew nothing about him or his best interests. He was interrogated by the many, many, many social workers, lawyers, and other child advocates required to visit him, all asking the same questions. He had no sense of control, with his old life or this crazy new one, and it drove him nuts. He was five years old, and acted out accordingly, with tantrums, and fits of rage. I can't say that I blame him.

But we got over it all. Slowly, we learned to navigate his diabetes together. He learned to communicate instead of raging, and to trust that I wasn't going anywhere. He learned to adapt to a new home, a new school, a new mom, and a big, extended family. I learned that my family and friends exceeded all of my expectations of love, that they were giving and supportive beyond belief, and without expecting anything in return. Their love and support got me through the toughest times in my life.

I learned patience, with a scared little boy and with a messed-up, red-tape bureaucratic system that functioned solely to complicate my life and drag out the whole adoption process (that's what it felt like). I learned to trust that while social workers didn't always bring good news (another birth mother appeal granted--again??), they fought for us again and again, as overworked and underpaid as they were. I learned that they didn't like filling out all the reams of paperwork any more than I did, and yet, they never complained.

I learned to function sleep-deprived, and Mark learned to ignore me when I was cranky and tired. I learned that beneath all that fear and anger was a happy, sweet, funny little boy who smiled easily, laughed loudly, and loved freely. He learned that there wasn't anything I wouldn't do for him, and I learned that I could love someone, little as he was, more than I ever imagined.

And that was where we were at a year ago today, arriving at the judge's chambers. We'd settled into our lives, and when the judge proclaimed us a forever family, it was only a formality. It was just the official stamp on the paper. Because I hugged Mark tightly, and as I watched my family and friends do the same, I knew that no matter what the date on the adoption certificate, we'd been family since that very first day.

So, happy Adoption Day, Mark. I'm proud to be your mom, and I love you.

May the snacks be with you

Yesterday, I spent my lunch hour--yes, the whole hour--shopping for afterschool snacks. This seems like a pretty easy task, until you factor in Mark's diabetes.

Then, choosing snacks becomes a complicated math problem. I add up the various factors to get my final result (healthy + low-carb + no refrigeration - refined flour + will he eat it = good snack). Fresh fruit's out of the question because Mark tosses his backpack around like a football, and by snack time, he's left with bruised, brown fruit he refuses to eat. Nuts are a really good snack--low-carb, full of fiber, healthy, but there's a kid in afterschool care with a peanut allergy, so I've eliminated things Mark loves--peanut butter crackers, granola bars, trail mix--that contain peanuts. That put a big dent in my snack répertoire.

So now browsing the snack aisle takes a good hour. I pick boxes carefully, examining the contents. Oooh, goldfish crackers--until I remember how high they send Mark. Granola bars and bites, an old standby--until I read the label, which says they may contain peanuts. Raisins--maybe. A fruit, and he might eat them. Excitedly, I put two boxes in my cart, and then realize I'm getting ahead of myself. He's 8--I may convince him to eat one package of raisins, but two is pushing it.

Cookies and chips--no. I don't mind the occasional treat, but I'm not sending them as a snack everyday. Likewise (fake) yogurt-covered anything, or rolled/gummy fruit snacks masquerading as dried fruit, but are really just gelatinous-shaped sugar bombs. Pretzels are an excellent choice--except that Mark hates them. South Beach bars and Scooby Snacks (little dog-bone shaped graham crackers) were good, but he ate so many, he burnt out on them. Yesterday I sent graham crackers, which came back uneaten, in a thousand crumbled pieces.

Last week, I thought I'd found the perfect snack--Sun Chips. They're full of multi grains, somewhat healthy, and labelled as chips, so Mark thought he was getting a treat. And he was, too, until he came home three days in a row with a blood sugar of almost 300, and another at 375. (His target range is between 70-150.) That officially ended our Sun Chips experiment, at least at school.

I eventually found enough semi-healthy, moderately low carb, yummy snacks I think Mark might eat, including:

• Popcorn
• Pudding cups
• Special K bars
• Raisins
• Teddy Grahams
• Granola bites (not the peanut butter ones)
• Crackers with cheese in the middle
• Chewy granola bars (not the peanut butter ones)

The crackers will send him high, and the granola bars MAY contain traces of peanuts, but I was tired of reading labels. Mark can suffer through the crackers in lieu of something tried and true, but boring, like Scooby Snacks. I'll warn the teachers of the granola bars--Mark can eat them outside and wash his hands afterwards. (The label says they may contain traces of peanuts.) Hopefully, he won't get close enough to the allergic kid to send him into anaphalactic shock.

I'm not complaining...things were a lot harder when Mark was on shots, and could only eat snacks under 15 grams of carbs. And he had to eat, whether he was hungry or not, or else the long-acting insulin would send him low. And he couldn't eat more, or he'd need a shot, which the afterschool counselors didn't feel comfortable giving him. Now, with the pump, it doesn't matter if he eats 15 carbs or 35 carbs, it's all one bolus. And he can work the pump himself (with adult supervision), which makes the adults less nervous than the needles did.

Anyway...this is what fills my head nowadays. Snacks that won't kill my kid, or any other kids. Carb counts. Insulin to carb ratios. Basal rates that change every couple hours, and are completely useless if Mark plays too hard or gets sick. And how to figure all that out silently, in my head, so that Mark doesn't have to worry about it, and can focus on being just like all the other kids.

So keep that in mind that the next time it seems like I'm not listening to you...I'm not being rude, I'm just worrying about how high those little cheese crackers will send Mark, or if I gave him a snack with enough protein to keep him from dropping low out on the playground!